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Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. ICM Index Number: 23/052 Authors: de Jong E, van Oers JA, Beishuizen A et al. Reference: Lancet Infect Dis 2016;16:819-827. Trial registration number: NCT01139489. © Elsevier Ltd. ICM ABSTRACT Objective To assess the efficacy and safety of procalcitonin-guided antibiotic treatment discontinuation in ICU p...
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Effect of aspirin on development of ARDS in at-risk patients presenting to the emergency department: the LIPS-A randomized clinical trial. ICM Index Number: 23/044 Authors: Kor DJ, Carter RE, Park PK et al. Reference: JAMA 2016;315:2406-2414. Trial registration number: NCT01504867. © American Medical Association. ICM ABSTRACT Objective To evaluate the efficacy and safety of early aspirin administration for the prevention of acute respiratory distress syndrome (ARDS). I...
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Medscape Nephrology > Viewpoints  COMMENTARY Is Timing Really Everything With RRT? Tejas P. Desai, MD August 08, 2016 Early Dialysis in Acute Kidney Injury For years we have been told that early interventions result in better patient outcomes. Early cardiac catheterization results in more preserved myocardial function. Early antibiotic therapy can lead to better results in patients with pneumonia. Patients with signs of an ischemic stroke can recover more neurologic fun...
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EDITORIAL SEPSIS: IMPLICATIONS OF THE IMPRECISE SCIENCE AND THE ANTIBIOTIC TREATMENT THEREOF I suspect one of the most influential articles of our time is the one by Anand Kumar and colleagues demonstrating that delayed antibiotic administration can lead to morbidity and mortality [1]. Not only has it been quoted over 1000 times, this single article has changed clinical practice. How often is it quoted "time to antibiotics" is important or a quality indicator of a syst...
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Defining Septic Shock Manu Shankar-Hari, Mervyn Singer JAMA 2016; 316: 456 In Reply 作者回复 Sepsis-3 defines septic shock as a life-threatening, generalized form of acute circulatory dysfunction (represented as vasopressor-dependent hypotension) associated with inadequate oxygen utilization (represented as hyperlactatemia), but with the important caveat of adequate fluid resuscitation. This definition has strong similarities to the consensus recommendations [1] cited by ...
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Defining Septic Shock Glenn Hernández, MD, PhD Flávia Machado, MD
Gustavo Ospina-Tascón, MD, PhD JAMA 2016; 316: 454-455 To the Editor 致编辑 The proposed new definition of septic shock, part of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), requires the simultaneous presence of hypotension and hyperlactatemia for making the diagnosis, instead of hypotension or hyperlactatemia. [1] In our opinion, this is a step backward compared wit...
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Comment & Response | July 19, 2016 Statins to Reduce Acute Kidney Injury After Cardiac Surgery—Reply Frederic T. Billings IV, Nancy J. Brown. JAMA. 2016;316(3):349-350. doi:10.1001/jama.2016.6148 In Reply 回复 Many patient characteristics may affect incidence of AKI following cardiac surgery, including exposure to iodinated radiocontrast agents and use of cardiopulmonary bypass. Aspirin use is common in patients presenting for cardiac surgery, and most patients are ...
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Clinical Criteria to Identify Patient With Sepsis Christopher W. Seymour, Derek C. Angus JAMA 2016; 316: 454   In Reply 作者回复 Both letters suggest misunderstandings about the scientific goal of the task force, which was to explore the predictive validity of diagnostic criteria for sepsis. There is no gold standard for sepsis, which precludes simple measures of validity based on the presence of true positives (cases with sepsis) and true negatives (controls without sepsi...
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Clinical Criteria to Identify Patients With Sepsis 鉴别全身性感染患者的临床标准 Anil N. Makam, Oanh Kieu Nguyen JAMA 2016; 316: 453 To the Editor 致编辑 Dr Seymour and colleagues [1] assessed the predictive validity of various clinical criteria to identify patients with sepsis. However, their conclusion that the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores are more clinically useful than the systemic inflammatory response syndr...
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Medscape Medical News Calf DVT: Anticoagulation Lowers Risks, but at a Cost Veronica Hackethal, MD July 22, 2016 Anticoagulation for an isolated calf deep vein thrombosis (DVT) appears to decrease the risk for pulmonary embolism (PE) or proximal DVT by two thirds, but quadruples the risk of bleeding, according to a study published online July 20 in JAMA Surgery. 根据7月20日在JAMA Surgery在线发表的一项研究,针对单纯小腿深静脉血栓形成(DVT)进行抗凝治疗能够使肺动脉栓塞(PE)或...
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